This document outlines medical examination procedures for workers required to work at heights. It describes conducting detailed physical, clinical, and neurological exams to assess stamina, mobility, strength, and check for medical conditions like diabetes, heart and lung diseases. Investigations like ECG, audiometry and blood tests are also done. Conditions resulting in disqualification include uncontrolled diabetes, vertigo, epilepsy and impaired vision or hearing. A step test is conducted to measure aerobic capacity and ensure it is at least 80% of maximum. Workers must self-certify that they have no medical issues or height phobias that would make working at heights dangerous. The goal is to place medically fit people in jobs and achieve zero accidents.

1. SOP-Pre –employment Medical Examination-
Working at Height
 Purpose:
 Working at height is defined as work undertaken at any place above or
below ground level(1.5 mtrs and above).the dangerous activities carried
in the construction, maintenance and facilities management industries.
It exposes the worker to fall from height and cause serious injuries. To
undertake these activities the person require suitable
stamina,mobility,strength and should be medically fit.

2. Objectives
 Zero Accident
 Place right person at right job

3. Scope
 All the workers executing work at height

4. Medical Examination
 As soon as person selected for above category should be sent health
center/OHC for detailed medical examination which includes:
1. General physical examination
2. Clinical examination
3. History of medical condition
4. History of Medication
5. Vision check-Near/distant/binocular/depth of vision/squint/diplopia/color
vision
6. Hearing Status
7. Neurological examination
8. Physical stamina, general body and flexibility
9. Body mass

5. Medical Examination-2
 Check hernia/Hydrocele
 Limb Function
 Whisper test
 Step-Test—Chester test/Heart rate monitoring
 Grip strength test
 Heel to toe walking test
 Physical fitness test
 Blood Pressure
 Peak flow meter test
 Cardiac and lung function status

6. Medical conditions-Attention to be paid
 Diabetes
 Sleep Disorders
 Epilepsy
 Vertigo
 Acrophobia
 Herat disease
 Lung Disease
 Kidney disease

7. Investigations
 ECG
 Audiometry
 Blood Sugar
 Urine R/M
 CBC
 Pulmonary function test
 EEG
 Liver & kidney profile
 Stool R/M

8. Medical Condition-Disqualification
 Insulin dependent diabetes
 Uncontrolled diabetes
 Vertigo
 Positive Acrophobia test
 Psychiatric illness
 Epilepsy
 Impaired Vision
 Impaired Hearing
 Indirect Hernia
 Cardiac disease
 Lung disease
 High Blood pressure
 Obesity

9. Step Test
 Instrument required-Chester step, Heart rate monitor, Graphical data sheet
 Ensure medical conditions
 H/O Medication
 Fit heart rate Monitor
 Start the test in progressive manner-the step is no longer than 30 cm and
candidate has to manage his body weight in controlled manner
 Increase gradually after every 2 mins
 Check heart rate every 2 mins
 Calculate Mx. Heart rate (220-age)
 Continue the test till heart rate reaches 80% of its maximum
 Plot the aerobic capacity on graphical data sheet.

10. Self certification
Particulars Yes No
Do you suffer from any heart
disease?
Do you have height phobia?
Are you diabetic?
Are you on medication?
Are you suffering from epilepsy?
Do you ever suffered from lung
disease?
Do you have claustrophobia?
Do you suffer from hearing problem?
Do you suffer from CNS disorder?
Are you suffering from psychiatric
illness?

11. Dr.Ashok Laddha—Occupational Health
Physician

12. Self Certification-2
 Do you know any other reason to consider yourself unfit?
 If answer is yes to any of the above question. you should not undertake
climbing activities until you have consulted Medical expert.
 Certification: I CONFIRM TO THE BEST OF MY KNOWLEDGE THAT
I AM IN GOOD PHYSICAL CONDITION AND HAVE THE
PHYSICAL STRENGTH AND STAMINA TO UNDERTAKE THE
CLIMBING ACTIVITY.